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Author
Topic: Now what do I do? (Read 4898 times)

I am encountering an increasing number of people who, aside from having HIV, have mental health issues.

I can deal with people suffering with depression, AIDS-related dementia and the like. But I also deal with people who hear voices telling them to do things.

In one case, there is a woman who will tell me she has been talking to God. That means its a good day. If she says she's been talking to the devil, I was advised by some local health care professionals to call the cops and hope they get there before something happens.

I want to help, but don't know how and it is really beginning to frustrate me.

To make matters worse, some of these folks are self-medicating, often with crystal meth. Not a good idea. It really does complicate things.

First up I applaud you for your work. It's heartening to know that people with mental illness can turn to you for support.

People with mental illness (as you'd know) are amongst the most marginalised and oppressed in our societies. Nevertheless, the can also exhibit the most "challenging behaviours." If you ever fear for your safety or the safety of others or indeed the safety of the mentally ill person then you need to call the police.

However, I understand your concern. Handing the people with severe psychotic conditions over to the coppers is never an easy thing. In Australia far too many people in prison should really be in mental wards. Do you have an effective network of mental health workers you can refer people to? I know that your home state is a little more progressive than others when it comes to drug issues. Are there effective drug and alcohol services who can help here?

MtD(Who knows only too well the appalling way in which the mentally ill are treated)

I am encountering an increasing number of people who, aside from having HIV, have mental health issues.

I can deal with people suffering with depression, AIDS-related dementia and the like. But I also deal with people who hear voices telling them to do things.

In one case, there is a woman who will tell me she has been talking to God. That means its a good day. If she says she's been talking to the devil, I was advised by some local health care professionals to call the cops and hope they get there before something happens.

I want to help, but don't know how and it is really beginning to frustrate me.

To make matters worse, some of these folks are self-medicating, often with crystal meth. Not a good idea. It really does complicate things.

Damn Ronald Raygun.

Any suggestions?

Mark

From the postings I've seen on this Forum, perhaps this is not the best place to ask for suggestions on what to do about such an issue? There seems to be quite a few posting here on this forum that are also suffering with depression, AIDS-related dementia, mental health issues and the like.

Damn Ronald Raygun? Huh? You're not blaming that dead prez from the last century are you?

There isn't as much help here as is needed. We do now have a psychiatric wing in the local hospital.

Up until a few years ago, the nearest was Albuquerque, three hours away.

Luring psychiatrists/psychologists/couselors to the boonies isn't easy either. Most opt for more urban areas where greater financial rewards can be reaped.

This also highlights the plight of those who are indigent or unable to cough up the usually considerable dough needed for care.

While the law now requires health insurance plans to cover mental health as well as physical health, most of the people I see are either uninsured or are on medicaid/medicare, which is government-supported health care.

I have managed to enroll a counselor with us here, so at least I can refer people to her and she can refer people to other care if need be - and if a payor source can be found. That is something, I guess.

I just feel woefully inadequate in dealing with this and wish there was some way to change that.

Dane, I can deal with depression, dementia and the like. It is the more serious or, should I say, overt mental health issues such as schizophrenia that gives me pause.

And, yes, I am blaming Ronnie Reagan. It was he who dismantled the mental health care system in in this country, saying private money and care would take up the slack.

I disagree (rsepectfully) with Dane about posting this here. Mental health issues are leading concern for HIV positive people. Just because some here may have such problems is certainly not a reason to avoid discussing such issues. Also Living With is a high traffic forum, and Mark will get more responses here.

Mark,

Will the organisation you work for send you for some training in working with people with mental health issues? If an increasing number of your your clients present with these issues, it seems to me that your organisations needs to equip you accordingly.

I'd like to totally agree with Matty about seeing if you can't get some training yourself. If that isn't possible, read. There are loads of very good books out there on counseling.

It might also help to work as closely as you can with your local drug/alcohol organisation. The link between drugs (self-medication) and schizophrenia are well documented. Hopefully your system is better than the one here on the Rock. The mental health team won't take on someone who has drug issues and the drug and alcohol team won't take on someone who has mental health issues. How's that for a catch-22? It sucks and was part of the reason why I didn't go back into drug work after my illness last spring (05). I couldn't take the stress of being angry and frustrated every day at work.

You're not kidding that people with mental health problems are greatly stigmatized and the people who are also living with hiv slip through the cracks at an alarming rate. I've ranted on about this in another thread... I'm convinced that one way to slow this pandemic down it to look after the mental health of positive people. But nobody seems to care. ~sigh~

Good luck Mark. Make sure you have someone to off-load this stuff to face-to-face as well. You need to look after you too... as you were telling us women.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

This is such a rough problem. Schizophrenia, and other psychotic problems can be a great challenge, and if the person is self-medicating it can be really difficult.

Would there be any psychiatrists who would want to do pro-bono work for your clients? Could you call the APA, or your state mental health board for guidance? There is a branch of the APA that specializes in HIV. I had the link at one point, and will look for it, and send it your way.

I agree with Ann and Matty, education for yourself is a good idea. You don't want this to burn you out.Christine

From the postings I've seen on this Forum, perhaps this is not the best place to ask for suggestions on what to do about such an issue? There seems to be quite a few posting here on this forum that are also suffering with depression, AIDS-related dementia, mental health issues and the like.

Damn Ronald Raygun? Huh? You're not blaming that dead prez from the last century are you?

I've got a lovely bunch of coconuts.....

Dane,

THIS IS THE ONLY PLACE THAT IS SAFE TO DISCUSS THE ISSUES OF MENTAL HEALTH AND LIVING WITH HIV. IF YOU DON'T THINK IT IS, THEN THAT IS YOUR OPINION, AND YOURS ALONE.

As for singling out Ronnie Raygun........ My dear Dane, have you absolutely no idea about what has led us to this world wide pandemic of HIV?? Don't you realize that this man was accountable for more HIV deaths than any singular person in American Government than anyone else before or since? 25,000 people in the Gay Community and the Hemopheliac Community DIED, TURNED TO DUST, EXPIRED, SUFFERED EXCRUCIATING DEATHS;BEFORE he would even say HIV or AIDS in public. No my friend, as long as I am alive, and have a memory of all the friends I have buried, (current score is 186) then you will have to listen to us old dinosaurs lament idiodic governmental policies around HIV and Mental Health.

Finally your cynical comment at the close concerning coaconuts is very inappropriate and you are not a special person, so please don't set yourself up as one.

Mark..... I feel for you, and I understand your quandry. I hope you can find some way to work at peace with this unfortunate situation. Just remember, you can only do what you can do, and no more.

In Love and Support.

Logged

The Bible contains 6 admonishments to homosexuals,and 362 to heterosexuals.This doesn't mean that God doesn't love heterosexuals, It's just that they need more supervision.Lynn Lavne

I remember when Reagan was governor of California and he put all the mentally ill out on the street to help cut California's budget. And his stupid trickle down economics. (More like piss on Mr. Middle America) if I ever get to southern California, I think Iíll stop by and piss on his multi-million-dollar grave.

Mark,Just want to say thank you for doing what you do and for caring about it so much. I've fought depression for many years. More importantly, my sister has been dianosed as borderline bi-polar. I know that she self-medicates with booze and many different drugs. It is such a difficult thing for me to see in my own family, I can't even imagine what you must witness. Thank you again for trying to help these people.

And I agree about reagan, evey time I see mentally-ill homeless people I think about Reagan and the mess he left us with.

Sorry, I can't be of too much help as this is an area I have very little expertise or knowledge in. I do recall you saying that many of these patients are self-medicating with crystal. I know that long use of cocaine can have the same auditory hallucinations as well. I guess the first step in addressing mental health issues is to figure out what is causing them. If it is due to drug use then there's the starting point. How to manage it...I'll leave that for someone far more qualified to answer than moi!